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MEDOP BEHAVIORAL HEALTH ASSOCIATES PC NPI 1053360677


NPI Information

NPI: 1053360677
Provider Name: MEDOP BEHAVIORAL HEALTH ASSOCIATES PC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
55 HATCHETTS HILL RD
OLD LYME, CT
ZIP 06371
Phone: (800) 370-3651
Get Directions

MEDOP BEHAVIORAL HEALTH ASSOCIATES PC is a neurology psychiatry neurology in Old Lyme, CT. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. MEDOP BEHAVIORAL HEALTH ASSOCIATES PC NPI is 1053360677. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

55 HATCHETTS HILL RD
OLD LYME, CT
ZIP 06371-534
Phone: (800) 370-3651
Fax: (877) 515-7147

The provider's authorized official is Donna Dooley .
The authorized official title is Chief Financial Officer and has the following contact phone number (800) 370-3651.

The enumeration date for this NPI number is 5/9/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalNo
21041C0700XSocial WorkerClinicalNo
32084P0800XPsychiatry & NeurologyPsychiatryNo
42084P0805XPsychiatry & NeurologyGeriatric PsychiatryNo
5363AM0700XPhysician AssistantMedicalNo
6363L00000XNurse PractitionerNo
7363LA2100XNurse PractitionerAcute CareNo
8363LA2200XNurse PractitionerAdult HealthNo
9363LF0000XNurse PractitionerFamilyNo
10364SA2200XClinical Nurse SpecialistAdult HealthNo
11364SP0808XClinical Nurse SpecialistPsychiatric/Mental HealthNo
12364SP0809XClinical Nurse SpecialistPsychiatric/Mental Health, AdultNo
13364SP0813XClinical Nurse SpecialistPsychiatric/Mental Health, GeropsychiatricNo
142084N0400XPsychiatry & NeurologyNeurologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004262531-MDMEDICAIDCONNECTICUT
2004266004-PHDMEDICAIDCONNECTICUT
3004266020-NPMEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.